We carried out an announced comprehensive inspection of Wholistic Medical Centre on 19 June 2018. We found that this service was not providing some areas of safe care. The full report for the comprehensive inspection can be found by selecting the ‘all reports’ link for Wholistic Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focussed inspection carried out on 4 December 2018 to confirm that the practice had made improvements since the inspection on 19 June 2018. We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This report covers our findings in relation to the improvements made since our last inspection.

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Wholistic Medical Centre provides private medical services in the City of Westminster in London. Services are provided to both adults and children aged five and above. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by a medical practitioner, including the prescribing of medicines.

Our key findings were:

• Control of substances hazardous to heath (COSHH) risks were assessed and well-managed.
• There were improved systems to assess and manage risks relating to infection prevention and control.
• The service had introduced formal systems to verify patients’ identity.
• Systems to appropriately communicate with patients’ GPs were operating effectively.
• The service had introduced a system to monitor the quality of medical records including consent processes, via quarterly records audits. An example of these were seen.

There were areas where the provider could make improvements and should:

• Monitor the recently introduced systems for recording the cleaning of clinical equipment and fabric examination couch coverings.

We carried out an announced comprehensive inspection of Wholistic Medical Centre on 19 June 2018 to ask the service the following key questions: Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care as there were some areas of risk management which were not fully established on the inspection day including those related to infection control and the control of hazardous substances. Risk management systems were introduced after the inspection to address these areas.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations, however, improvements were required in order to ensure that consent to treatment was obtained appropriately.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations, however in some areas the provider’s governance arrangements required a review in order to ensure that these supported the effective mitigation of risk.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Wholistic Medical Centre provides private medical services in the City of Westminster in London. Services are provided to both adults and children aged five and above. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by a medical practitioner, including the prescribing of medicines.

We received feedback from 16 people about the service, including comment cards, all of which were positive about the service and indicated that patients were treated with kindness and respect. Staff were described as empathetic, caring, thorough and professional.

Our key findings were:

• There were arrangements in place to keep patients safe and safeguarded from abuse.
• Most health and safety and premises risks were assessed and well-managed.
• There were safe systems for the management of medicines.
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.

• The premises were clean and hygienic, however infection control systems were not clearly monitored at the time of the inspection.

• The service had systems for recording, acting on and improving when things went wrong.
• Assessments and treatments were carried out in line with relevant and current evidence based guidance and standards.
• There was evidence of some quality improvement measures.
• Staff had the specialist skills and knowledge to deliver the service.
• Staff treated patients with kindness, respect, dignity and professionalism.
• Patients were able to book appointments when they needed them.
• The service had a clear procedure for managing complaints. They took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• The leader had the skills and capacity to deliver the service and provide high quality care.
• Staff stated they felt respected, supported and valued. They were proud to work in the service.
• There were clear governance arrangements for the running of the service.
• The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.
• The service asked staff and patients for feedback about the services they provided.

There were areas where the provider could make improvements and should:

• Continue to monitor the systems for assessing and managing risks related to infection control and the control of

  substances hazardous to health.

• Review the system for monitoring consent including the undertaking of records audits.

• Monitor the systems for

  communicating with a patient’s GP and verifying a patient’s identity.